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Yemen

Health Systems 20/20 focuses on strengthening a decentralized health system in five of the most vulnerable and underserved governorates in Yemen. Project activities support the Ministry of Public Health and Population’s (MoPHP) Health Sector Reform Strategy and USAID/Yemen’s strategy to increase the use of reproductive, maternal, and child health services.

Health Information as the Foundation for Better Management of Health Resources and Better Governance

Policymakers, providers, and civil society organizations such as the Midwives Association, can access health news, reports, statistics, and reliable data—including an interactive viewer and mapping tool on all private and public health facilities at http://www.mophp-ye.org.

Health Information Systems/Geographic Information Systems (HIS/GIS) tools and applications developed by Health Systems 20/20 allow health professionals to visually explore patterns in health indicators and identify gaps in services - including staffing, drugs, equipment, infrastructure, populations served, and accessibility to health facilities - to prioritize resource needs. Each governorate and district has an Atlas with maps of precise geographic locations, photos, and summary information about each health facility.

A health GIS toolkit designed as an extension for ArcView GIS software can be readily transferred to any country context to enable unique health-focused targeting tools to utilize health information in better ways. The HealthAnalyzer application runs on a CD-ROM and allows decision makers at the sub-national level with access to a computer to take advantage of evidence-based decision-making capacity by utilizing health and GIS data to inform decisions and visualize results. Read more about HIS and an overview of health GIS support in Yemen.

Health Systems 20/20 is coordinating with the World Bank to add value to HIS support they provide by training MoPHP staff at the national and governorate levels on how to make better decisions using GIS-enhanced, evidence-based solutions. Governorate health officials have begun shifting resources based on the results.

Health Systems 20/20 is also piloting a new “one form” electronic patient record system in the Al Joomhori Hospital in Saadah to demonstrate increased efficiency, accuracy, and utilization of the HIS at the point of service by streamlining the multiple registry system currently used across vertical programs. MoPHP recognizes the need for HIS reforms, and Health Systems 20/20 is participating and providing technical guidance alongside WHO in the Health Metrics Network HIS assessment process with the MoPHP and donors and developing a strategic plan for making improvements.

Capacity Building in Health Financing, Operations and Governance

Because of decentralization, governorates are being empowered to make financing decisions. Health Systems 20/20 is assisting MoPHP implement the national health sector review patterned after the USAID health systems assessment framework and its application in Angola.

The Governorate Health Office needs systems for health planning, budgeting, and funds disbursement that are transparent and based on real needs. Health Systems 20/20 is training governorate level staff to produce Governorate Health Accounts using the NHA methodology, ensuring that the financial data becomes a component of the health information system. Health Systems 20/20 is improving the skills of managers for better operations:  data collection and analysis, financial management, budgeting, planning, and implementation of programs.

Strengthening Routine Immunization and Surveillance to Prevent Disease at a Lower Cost

In collaboration with UNICEF and the Capacity Project, Health Systems 20/20 is expanding routine immunization outreach, data collection, and analysis. Strong routine immunization and surveillance programs reduce morbidity and mortality by ensuring that vaccine coverage is high, reducing vaccine wastage and stockouts, identifying outbreaks earlier, and reducing the need to rely on resource-intensive special vaccination campaigns. In April 2007, WHO's Regional Office for the Eastern Mediterranean (EMRO) and the Ministry of Public Health & Population (MOPH&P) conducted a quick assessment of the immunization management information system (MIS) being piloted in the Amran governorate. The MIS was developed and initially piloted in Amran through PHRplus, and Health Systems 20/20 is now supporting expansion of its implementation from Amran into the Marib Governorate. The team visited the governorate National Expanded Programme on Immunization (EPI) office and EPI store, and the Jabal Iyal Yazid District because of low Pentavalent-3 coverage for 2006 (less than 75%) and found that the MIS provided an excellent way to determine the catchment area for immunization activities. The MIS revealed that about 20% of children from the Al Jabal Iyal Yazid District were vaccinated in the neighboring Amran District, which means that the coverage is not as low as reported. The MIS also improved stock management to prevent stockouts, excess supply, and expiration wastage. The EMRO team strongly recommended the MIS and encouraged expansion to other USAID-supported governorates. The assessment team recommended, and is working with the EPI to develop a country-wide MIS expansion strategy.